Implementation of the Standards for adult immunization practice: A survey of U.S. Health care providers.

Autor: Granade CJ; Immunization Services Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, 1600 Clifton Rd NE, Mailstop H24-4, Atlanta, GA 30326, United States; Oak Ridge Institute for Science and Education, U.S. Department of Energy, P.O. Box 117, Mail stop 36, Oak Ridge, TN 37831, United States; IHRC Inc, 2 Ravinia Dr Suite 1200, Atlanta, GA 30346, United States. Electronic address: ori9@cdc.gov., Parker Fiebelkorn A; Immunization Services Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, 1600 Clifton Rd NE, Mailstop H24-4, Atlanta, GA 30326, United States. Electronic address: dez8@cdc.gov., Black CL; Immunization Services Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, 1600 Clifton Rd NE, Mailstop H24-4, Atlanta, GA 30326, United States. Electronic address: zwc0@cdc.gov., Lutz CS; Immunization Services Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, 1600 Clifton Rd NE, Mailstop H24-4, Atlanta, GA 30326, United States; Oak Ridge Institute for Science and Education, U.S. Department of Energy, P.O. Box 117, Mail stop 36, Oak Ridge, TN 37831, United States; Department of International Health, Johns Hopkins Bloomberg School of Public Health, 615 N Wolfe St, Baltimore, MD 21205, United States. Electronic address: clutz8@jhu.edu., Srivastav A; Immunization Services Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, 1600 Clifton Rd NE, Mailstop H24-4, Atlanta, GA 30326, United States; Leidos Inc, 2295 Parklake Dr NE, Atlanta, GA 30345, United States. Electronic address: xbs2@cdc.gov., Bridges CB; Berry Technology Solutions, Inc, 19 E. Broad St, Suite B, Newnan, GA 30263, United States; Immunization Action Coalition, 2550 University Ave W, Suite 415, St. Paul, MN 55114, United States. Electronic address: carolyn.bridges@immunize.org., Ball SW; Abt Associates Inc, 10 Fawcett St, Suite 5, Cambridge, Massachusetts, United States; Westat, 1600 Research Blvd, Rockville, MD 20850, United States. Electronic address: SarahBall@westat.com., Devlin RG; Abt Associates Inc, 10 Fawcett St, Suite 5, Cambridge, Massachusetts, United States. Electronic address: Rebecca_Devlin@abtassoc.com., Cloud AJ; Abt Associates Inc, 10 Fawcett St, Suite 5, Cambridge, Massachusetts, United States. Electronic address: Ann_Cloud@abtassoc.com., Kim DK; Immunization Services Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, 1600 Clifton Rd NE, Mailstop H24-4, Atlanta, GA 30326, United States; United States Department of Health and Human Services, 200 Independence Ave S.W., Washington, DC. 20201, United States. Electronic address: David.Kim@hhs.gov.
Jazyk: angličtina
Zdroj: Vaccine [Vaccine] 2020 Jul 14; Vol. 38 (33), pp. 5305-5312. Date of Electronic Publication: 2020 Jun 22.
DOI: 10.1016/j.vaccine.2020.05.073
Abstrakt: The revised Standards for Adult Immunization Practice ("Standards"), published in 2014, recommend routine vaccination assessment, strong provider recommendation, vaccine administration or referral, and documentation of vaccines administered into immunization information systems (IIS). We assessed clinician and pharmacist implementation of the Standards in the United States from 2016 to 2018. Participating clinicians (family and internal medicine physicians, obstetricians-gynecologists, specialty physicians, physician assistants, and nurse practitioners) and pharmacists responded using an internet panel survey. Weighted proportion of clinicians and pharmacists reporting full implementation of each component of the Standards were calculated. Adjusted prevalence ratio (APR) estimates of practice characteristics associated with self-reported implementation of the Standards are also presented. Across all medical specialties, the percentages of clinicians and pharmacists implementing the vaccine assessment and recommendation components of the Standards were >80.0%. However, due to low IIS documentation, full implementation of the Standards was low overall, ranging from 30.4% for specialty medicine to 45.8% in family medicine clinicians. The presence of an immunization champion (APR, 1.40 [95% confidence interval {CI}, 1.26 to 1.54]), use of standing orders (APR, 1.41 [95% CI, 1.27 to 1.57]), and use of a patient reminder-recall system (APR, 1.39 [95% CI, 1.26 to 1.54]) were positively associated with adherence to the Standards by clinicians. Similar results were observed for pharmacists. Nonetheless, vaccination improvement strategies, i.e., having standing orders in place, empowering an immunization champion, and using patient recall-reminder systems were underutilized in clinical settings; full implementation of the Standards was inconsistent across all health care provider practices.
Competing Interests: Declaration of Competing Interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Regarding the present manuscript, the following co-authors do not report and conflicts of interest: Charleigh J. Granade, Amy Parker-Fiebelkorn, Carla L. Black, Anup Srivastav, Chelsea S. Lutz, Carolyn B. Bridges, and David K. Kim. Because the data presented in this manuscript was collected through a contractual agreement between CDC and Abt. Associates, the following co-authors report a conflict of interest: Sarah W. Ball, Rebecca G. Devlin, and Ann J. Cloud..
(Copyright © 2020 Elsevier Ltd. All rights reserved.)
Databáze: MEDLINE
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